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Apart from the genetic and foetal origin, two major factors, according to health experts contribute to the alarming rise in diabetes: poor diet and lack of exercise. The stress is also another main factor which aggravates the illness. The attitudes of the present generation who are hooked to fast food than the traditional balanced diet that causes a rapid increase in blood sugar. The healthy traditional food items with less oil and carbohydrates have been overlooked with sweets, French fries, potato chips and lots of mouth watering fast food items full of oil. According to Dr. Wijesuriya, the illness has spread its wings from the city to rural areas where a lots of poor people are now more prone to diabetes. What is insulin? It is a hormone that is needed to convert sugar, starch and other food into energy needed, for daily life. Without insulin your body cannot get the energy it needs from your food. This hormone is made by a gland in the body called the pancreas. Most of our food intake is turned into glucose, a form of sugar which our body uses for energy. Insulin helps the glucose get into the cells of the body to provide energy. Types of diabetes: There are two main types of diabetes. Type 1 : This is called insulin-dependent diabetes (IDDM). Patients require insulin for survival and this occurs when very little or no insulin is produced. It develops most often in children and young adults and is also found in adults. The onset is usually sudden and dramatic. This accounts for about 10 per cent of all diabetes in the country. Type 2: This is called non-insulin dependent diabetes. Patients do not generally require insulin in administration for survival. This occurs when the body is unable to produce sufficient insulin to meet its requirements or it cannot utilize the insulin that is produced effectively. Type 2 diabetes can be controlled through diet, routine exercise and oral medication. This, which is recorded among adults is becoming common in young people, including children and teens. The onset is gradual and therefore hard to detect and accounts for about 90 per cent of the total diabetes population. What is diabetes mellitus? It is a chronic condition that arises when pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces which leads to raised blood glucose levels. What are the types? Type 1/Insulin Dependent: Childhood onset and they produce very little or no insulin - Insulin deficiency Type 2/Non Insulin Dependent: Adult onset and they cannot use insulin effectively that has been produced in body - Insulin resistance Gestational Diabetes Mellitus (GDM): Pregnancy induced state of insulin resistance. Who are at risk? Family history of diabetes Physical Inactivity Unhealthy diet Stress (Occupation/financial/educational/nutritional or illness) Overweight or obese History of GDM What are the symptoms? Increased thirst and dry mouth Frequent urination Constant hunger Sudden weight loss Extreme tiredness or lack of energy Delayed wound healing Recurrent infections Blurred vision Is there a cure? NOT - only control and prevention What are the complications? Heart disease/stroke Kidney disease Blindness Sensory impairment Amputations Prevention of diabetes 1.Modifying the risk factors of people (Primary prevention) 2.Treating and effectively diagnosed diabetics to prevent development of complication (Secondary prevention) 3.Preventing further deterioration of complications and rehabilitating disabled due to complications (Tertiary prevention) How to achieve? Primary prevention 1.General population (General public, health care professionals and policy makers) Education Awareness Advocacy 2. High risk Family history Physical inactivity Increased waist Increased BMI Secondary prevention Early detection Correct guidance and treatment Good compliance: responsibility with patient/family/doctor/policy maker Regular monitoring/complication detection Tertiary prevention Correct management of life threatening complications: Heart/Kidney/Eye/Limb/Brain Availability of medications/Complications assessment/Intensive care and follow up Availability of other specialised care/rehabilitation teams. Children and adolescence More and more children are at risk in the world as a result of dietary changes, lack of physical activities. One in ten children in the world is over weight. 22 million of them are under 5 years of age. 85% of children with Type 2 diabetes are over weight or obese. African, Hispanic, Asian and Native American children are more at risk. Type 1 is also rising at an alarming rate of 3% a year. 70,000 children a year develop Type 1 diabetes annually. **** How is it diagnosed? Fasting Blood Sugar test (mg/dl) <100 Normal 100-125 At risk of diabetes >126 Diabetes Post Prandial Blood Sugar Test (mg/dl) <140 Normal 140-199 At risk of diabetes >200 Diabetes *** Global prevalence rate of diabetes Global pandemic 2006 - 246 million 2025 - 380 million In 2025, 80% of them will be in low and middle income countries (Sri Lanka is one of them) Type 2 diabetes accounts for 90% of the all the diabetics 50% with the disease are unaware of condition 3.2 million people die every year of diabetes related illness globally (More than HIV/AIDS - 3 million) 2.5% million diabetics become blind - commonest cause **** Prevalence rate of diabetes in Sri Lanka Year Prevalence (Islandwide) Urban Rural 1990 2.5% 5 2 2000 6.5% 7.7 12 2007 10.2% 16 8.6 **** Guide to find the ideal body weight for height (BMI-23) Height Maximum Height Maximum (Feet, Weight (Feet, Weight Inches) (kg) Inches) (Kg) 4’5” 41.01 5’6” 64.6 4’6” 42.57 5’7” 65.54 4’7” 44.16 5’8” 67.51 4’8” 45.78 5’9” 69.51 4’9” 47.43 5’10” 71.54 4’10” 49.11 5’11” 73.6 4’11” 50.82 6 75.68 5 52.56 6’1” 77.8 5’1” 54.32 6’2” 79.95 5’2” 56.12 6’3” 82.12 5’3” 57.95 6’4” 84.33 5’4” 59.8 6’5” 85.56 5’5” 61.68 6’6” 88.82 |
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